Bagdonaite Laura, Pearson Andrew R
Royal Berkshire Hospital , Reading , United Kingdom.
Orbit. 2015 Jun;34(3):132-6. doi: 10.3109/01676830.2015.1014507. Epub 2015 Apr 22.
Extrusion is the most common reason for failure after Jones tube placement. The StopLoss Jones tube (SLJT) is a new innovation in Jones tubes that incorporates a flexible silicone internal flange to resist extrusion. We present our early experience of using this new tube and associated introducer system.
We retrospectively analysed the case notes of a single surgeon consecutive series of patients having SLJT placement from November 2011 to November 2013.
29 SLJTs were placed in 25 eyes of 19 patients. Tube follow-up ranged from 1-25 months (mean 10 months) with a total of 291 tube-months. The indications for SLJT placement were: previous LJT complications (52%), failed canalicular-DCR surgery (31%), primary placement for inoperable canalicular occlusion (14%) and patent non-functioning DCR (3%). Tube length ranged from 10-16 mm. The tube introducer system was simple and effective and there were no intra-operative complications. The tube extrusion rate was 0%. Complications occurred in 5 tubes: 1 was too long, and 4 others (14%) developed conjunctival overgrowth/medial tube migration. Patient satisfaction with the tube was: 86% fully satisfied, 10% was moderately satisfied, 3% not satisfied. The overall final surgical success rate at last follow-up was 92%.
In this short follow-up initial study the SLJT is simple to use and has a high rate of success and patient satisfaction. The addition of the internal silicone flange appears to prevent the previously common problem of extrusion.
脱出是琼斯管置入术后最常见的失败原因。止损琼斯管(SLJT)是琼斯管的一项新创新,它采用了柔性硅胶内凸缘来防止脱出。我们介绍使用这种新导管及相关导入系统的早期经验。
我们回顾性分析了一位外科医生在2011年11月至2013年11月期间连续为患者置入SLJT的病例记录。
19例患者的25只眼中置入了29根SLJT。导管随访时间为1至25个月(平均10个月),总计291个导管月。置入SLJT的指征为:既往LJT并发症(52%)、泪小管 - DCR手术失败(31%)、因无法手术的泪小管阻塞而初次置入(14%)和通畅但无功能的DCR(3%)。导管长度为10至16毫米。导管导入系统简单有效,术中无并发症。导管脱出率为0%。5根导管出现并发症:1根过长,另外4根(14%)出现结膜过度生长/导管内侧移位。患者对导管的满意度为:86%完全满意,10%中度满意,3%不满意。最后一次随访时总体最终手术成功率为92%。
在这项短期随访的初步研究中,SLJT使用简单,成功率高,患者满意度高。内部硅胶凸缘的添加似乎预防了先前常见的脱出问题。